Global Health from the Ground Up

By Paul Hudson

PARIS – While the end of the COVID-19 pandemic may be “in sight,” as the World Health Organization recently declared, the world faces numerous emerging health risks. Some are exacerbated by climate change, others by travel, online misinformation, food scarcity, poverty, or wars. Fortunately, the pandemic has taught us valuable lessons for managing these risks – and for helping vulnerable developing economies better prepare for future health crises.

The WHO’s Access to COVID-19 Tools (ACT-A) Accelerator has been a massive global effort that facilitated testing, treatment, and vaccination worldwide. But it is clear that ACT-A failed to address the longstanding structural obstacles that impeded vaccination rollouts in low- and middle-income countries. Doing so requires a new framework that emphasizes local relationships with workers and entrepreneurs on the ground.

Developing countries have fewer health workers per capita than developed countries do. Africa, Southeast Asia, the eastern Mediterranean, and parts of Latin America face a shortfall of 5.9 million nurses and 18 million health-care workers by 2030. In 2019, 13.8 million infants worldwide did not benefit from routine immunization services, including 8.8 million from lower-income countries. It is hardly surprising, then, that only 16% of people in low-income countries have received at least one COVID-19 vaccine dose as of May, even though global supply now far outstrips demand.

Pharmaceutical companies have a crucial role to play in overcoming the various obstacles to boosting vaccination rates in lower-income countries. And, as we seek to ensure access for a broader array of treatments, the challenges extend beyond vaccinations. Current efforts by several manufacturers, Sanofi among them, include providing a portfolio of essential medicines at cost. For example, Sanofi’s Global Health Unit distributes 30 essential drugs – including insulin and treatments for cardiovascular disease, tuberculosis, malaria, and cancer – to 40 developing countries.

But while reducing treatment costs is vitally important, the pandemic demonstrated the need for a more holistic approach that views medicine, health-care systems, and the global supply chain as interconnected challenges. As COVID-19 showed, assistance that does not empower local capabilities can do more harm than good, which is why companies must go beyond merely providing financial aid. To help improve access to health care in low- and middle-income countries, companies can tackle logistical and supply issues, use their data and analytics capabilities to assist frontline responders, and train local officials in innovative technologies.

Public-health experts around the world are increasingly focused on identifying and managing emerging diseases and hot spots and reshaping attitudes and behaviors, while technology facilitates the data collection and information-sharing needed to improve outcomes. But gathering and assessing these data depends on collaboration with traditional and non-traditional partners. Such efforts must move rapidly, be driven by local communities’ priorities, and build on shared data derived from diagnostics, tracking, and modeling. During the pandemic, South Africa stood out for its prompt genomic sequencing, which involved cooperation among many actors and enabled the country to detect the Beta and Omicron variants early on.

Similarly, combining large data sets, computing power, and algorithms would allow public-health officials to monitor disease spread, material shortages, logistical challenges, and drug reactions. Cloud technology facilitates data mining, information-sharing, and research and development, and enables us to identify disease outbreaks, new pathogens, and communities most in need of immediate help.

To this end, the global public-health community should work together to enable innovation and cultivate entrepreneurial ecosystems by focusing on local startups. An Impact Fund to provide capital to local startups would need to be created, together with mechanisms for sharing skills and operational expertise. Sanofi Global Health’s $25 million Impact Fund, launched in July, is already supporting local innovators that are able to deliver scalable solutions for sustainable health care in underserved regions.

Given lower-income countries’ need for more medical workers, fostering local expertise is crucial. In emerging markets, local medical professionals and supply-chain experts must train to become “expert generalists” who can address pressing public-health concerns and reduce barriers to care.

Here, technology can provide an alternative to in-person training, which is becoming more challenging to manage as a result of rising costs, ongoing political conflicts, travel restrictions, and labor shortages. Sanofi, for example, is working together with Reach52, a tech platform from Singapore that offers rural districts health education, screening, and affordable medicines in one accessible subscription service. Reach52’s platform relies on an “offline-first” approach for low-connectivity markets, enabling local aid workers to enroll residents in community-based screening sessions for diabetes and hypertension, conducted by nurses trained as “health coaches.”

Increasing access to health care in low-income countries in a meaningful way requires more than providing them with low-cost medicines. We need a new framework of cooperation to address the myriad interconnected challenges we face as we adapt to new technologies and nurture local innovation. As pharmaceutical companies, our job is to disrupt our own thinking and encourage on-the-ground innovators. This multi-pronged approach must center on a sustainable, locally-driven care model designed to reach vulnerable populations. As the Nobel laureate economist Angus Deaton wrote, aid that gives but does not strengthen is unhelpful – and can even hinder future gains.

Paul Hudson is the CEO of Sanofi.